Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
Department of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
J Med Virol. 2019 Oct;91(10):1837-1844. doi: 10.1002/jmv.25533. Epub 2019 Jul 16.
Long-term prognosis of patients with chronic hepatitis C infection (HCV) remains incompletely characterized. We investigated the long-term prognosis of liver disease in patients with chronic HCV infection who have not received antiviral therapy.
A total of 2304 patients with chronic HCV who were not received interferon-based therapy were included.
In the assessment of 1-year disease state of liver transition probabilities, progression to chronic hepatitis occurred in 12% to 14% of patients across all age groups in male asymptomatic carriers. In male patients with chronic hepatitis, progression to cirrhosis was observed mostly in the 60 to 69 (7.6%) and ≥70 age groups (9.6%). In addition, in male patients with cirrhosis, HCC development occurred in approximately 5% of patients over the age of 40. In female asymptomatic carriers, progression to chronic hepatitis was observed in 6% to 14% of patients across all age groups. In female patients with chronic hepatitis, progression to cirrhosis was observed mostly in the 60 to 69 (8.7%) and ≥70 (7.4%) age groups. In addition, in female patients with cirrhosis, HCC development occurred in 0.9% to 3.3% of patients over the age of 50. Under assumptions of either chronic hepatitis or asymptomatic carrier state at age 40 as the starting condition for simulation over the following 40 years, the probability of HCC gradually increased with age and was higher in male patients.
There is a risk of cirrhosis or HCC development in HCV patients with not only chronic hepatitis but the asymptomatic carrier state as well.
慢性丙型肝炎病毒（HCV）感染患者的长期预后仍不完全明确。我们研究了未接受抗病毒治疗的慢性 HCV 感染患者的肝病长期预后。
共纳入 2304 例未接受干扰素治疗的慢性 HCV 患者。
在评估 1 年肝脏疾病状态的转移概率时，各年龄段男性无症状携带者中约有 12%至 14%的患者进展为慢性肝炎。在慢性肝炎的男性患者中，进展为肝硬化主要发生在 60 至 69 岁（7.6%）和≥70 岁年龄组（9.6%）。此外，在肝硬化的男性患者中，约有 5%的年龄大于 40 岁的患者发生 HCC。在各年龄段的女性无症状携带者中，约有 6%至 14%的患者进展为慢性肝炎。在慢性肝炎的女性患者中，进展为肝硬化主要发生在 60 至 69 岁（8.7%）和≥70 岁年龄组（7.4%）。此外，在肝硬化的女性患者中，年龄大于 50 岁的患者中，HCC 的发生率为 0.9%至 3.3%。在假设 40 岁时为慢性肝炎或无症状携带状态作为接下来 40 年模拟的起始条件下，HCC 的发生概率随着年龄的增长而逐渐增加，且男性患者的 HCC 发生率更高。
不仅慢性肝炎，HCV 感染者的无症状携带状态也存在发生肝硬化或 HCC 的风险。
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